Category: Nutrition

The food labels you’ve come to know and recognize are getting a facelift. On May 20, 2016, the Food and Drug Administration (FDA) introduced changes and updates to the food labels required on all manufactured food and beverage products. This is the first significant change to the label since the early 1990’s, and all companies must incorporate the changes by July 2018. According to the FDA, the new label design more accurately reflects the way Americans eat today as opposed to how they did in the 1980’s and 1990’s.

A key change to the label, and probably the most noticeable change, is that the calories are written in a large, bold font. This is meant so that a person can quickly see how many calories are in a serving. Additionally, standard serving sizes have also been updated to better reflect the increasing serving sizes in America. For instance, a standard ½ cup serving of ice cream on food labels now has been increased to 2/3 cup (have you ever tried to eat only a ½ cup of ice cream? It’s impossible!). And, a standard 8oz serving of soda is now 12oz. Calories are listed per serving, and sometimes per package, depending on if a person is likely to consume an entire package of a food item at once (i.e., a large bottle of soda containing two servings instead of one, or a bigger bag of chips).

Another change is the addition of a line under “carbohydrates” that discloses the amount of added sugars. Personally, I think this is a great idea, as it can bring awareness to how much added sugars someone can actually be consuming throughout the day. Increased calorie intake from added sugars can contribute to the development of obesity, heart disease, and certain cancers, so this is a very positive change. I think it may also encourage food companies to reconfigure their manufacturing processes to decrease the amount of added sugars in their products, now that the amount of added sugar will be fully on display.

The last of the major changes to the new food label are the vitamins and minerals that are required to be listed. Currently, the amounts of vitamins A and C, calcium, and iron are standard. The new label will now require Vitamin D and potassium content, and does not require Vitamins A and C. The FDA reports that the reasoning behind this change is because in the early 1990’s, more people were lacking vitamins A and C in their diets, however deficiencies are not that common today. Research has shown that more people are not consuming enough Vitamin D and potassium, which can lead to the development of certain chronic diseases such as osteoporosis or cardiovascular disease, respectively.

Take a look at the comparison between the old label and the new label below. What do you think of the changes? Do you think it will improve the health of the American people?

You can find a more detailed look and explanation of the new labels by the FDA here..

Lately I’ve been hearing a lot about pulses – that they’re the new “it” food of 2016. I’ve heard that they provide ample health benefits and are replacing things like quinoa, kale, and other exotic-sounding foods (that are bound to be hard to find and expensive) as the new life-changing power food. The word itself is ugly, and reminds me of a beating heart, and something that I definitely do not want to eat. I will be the first to admit that I actually had no idea what a pulse is. Have you heard of them? I was additionally reluctant to research them to find another nutrition fad that seems utterly ridiculous to me (sorry, Bulletproof coffee fans). But, I must say, I was pleasantly surprised to learn what pulses actually are, and to find that I’ve actually been eating them fairly regularly throughout my entire adult life.

What is a pulse?

A pulse is the dried seed portion of a legume. A legume is a plant whose fruit is enclosed inside a pod. Common legumes include soy, peanuts, and peas. Therefore, examples of a pulses are basically dried legumes. The most common types of pulses include dry lentils, chickpeas, dried peas, and dried beans.

What are the nutritional benefits?

Pulses are a filling part of any meal due to their high fiber and protein content. They are also very low in fat, so they’re a good choice to incorporate into your daily life if you’re looking to lose weight. The high fiber content helps protect against cardiovascular disease by lowering blood cholesterol levels. High fiber also helps to stabilize blood sugar levels by preventing spikes in blood sugar (which will later cause you to crash). Pulses contain a lot of protein for a plant source. For instance ½ cup of lentils contains approximately 9 grams of protein – more than an egg, which contains only 6 grams. Pulses are also nutritionally dense; they pack in a lot of different vitamins and minerals that are essential for energy production and metabolism in a very small package and for not a lot of calories. Pulses deliver a high amount of B-vitamins, folate, thiamin, and niacin, which are all important for neurological function and for energy fuel. The one downside to pulses? They may cause some gastrointestinal discomfort when eaten in large amounts, or if you’re not used to eating them all of the time. If you want to increase your pulse intake, add them into your diet slowly, and make sure to drink plenty of water to help things move through your digestive system smoothly.

How can I eat more pulses?

If you don’t feel like eating straight up beans, you can incorporate more pulses into your diet by eating foods that already contain them! Good sources include hummus, bean spreads, chili with beans, lentil soups, and dips. If you don’t care to be adventurous, you can add lentils, peas, and beans straight into your salad in place of higher-fat meat toppings. I personally love making a baked sweet potato and topping it with black beans, plain Greek yogurt, shredded cheddar cheese, and salsa for a cheap and SUPER filling dinner.

So, there you have the new, fabulous, exotic, and trendy food of 2016. As you can see, they’re really not so scary! Do you normally eat pulses? What’s your favorite way to get in these nutrition superstars?

Well, it’s been a quick minute, and in honor of National Nutrition Month, I thought there was no better time to resurrect the blog. I additionally thought it would be a good idea to talk about what exactly a clinical dietitian does. I wanted to write this post for students who are thinking about applying to a dietetic internship and/or a career in nutrition after they graduate. Or I thought this would be helpful for anyone looking to make the switch into dietetics. I know when I was in school I would have found a blog like this helpful in letting me know what to expect.

So, a lot of people ask me what I actually do, and a few have asked me to walk them through a typical work day for me. Here’s how it goes….

I come into work around 8:00 AM and log onto a program called CBORD, where I print out the floors that I’m assigned to. This is basically a roster of patients who are admitted, their diet orders, and when they’re due to be seen for a nutrition assessment or a follow up. I make up my list of patients that are due for that day and then log into the electronic medical record. Then, I look up my patients’ past medical histories, their labs, their weight histories, and their medications, and basically try to get a big picture about what’s going on with each individual patient. I take note of anything pertinent to their nutritional status and what may be interfering with their food intake. Then, once I have all of my patients’ information, I go up to the units and attend interdisciplinary rounds with the doctors, case managers, physical therapists, and social workers. There, I can figure out which patients have pressing nutrition issues, who should be seen by a dietitian, and can give recommendations to the doctors about my patients. Then, I’ll go around to each patients’ room and interview them. I find out how their appetite is, how they’ve been eating, if they’re having any nausea, vomiting, diarrhea, or constipation, any chewing/swallowing issues, any weight changes, etc. etc. etc. There’s surprisingly a lot of talk about bowel movements with strangers, so you really cannot be shy if you want this job.

If it’s necessary, I will give diet education to the patient and family members. I cover a cardiac unit and give a lot of heart healthy and diabetic diet education. I also cover a surgery unit so I talk a lot about appropriate diets for gastrointestinal surgeries. If a patient is having issues with eating or are likely not meeting their estimated calorie and protein needs (which can lead to weight loss, trigger pressure ulcer development, and impair the ability to fight off infections, among many other medical complications), we help the patient figure out how to increase their intake. If necessary, we may have to calculate tube feeds, which is a specialized formula consisting of calories, protein, vitamins, and minerals and is delivered to the patient via a tube through the nose or directly into the stomach. If the GI tract isn’t functioning, then we will write something called total parenteral nutrition, or TPN, which is basically a solution of dextrose, amino acids, lipids, and electrolytes that is infused via an IV.

There’s a lot more to being a clinical dietitian than it may initially seem. There’s a lot of math involved if calculating a TPN, tube feed rate, or even a calorie count (where the nurse writes down everything the patient eats to determine if a patient requires alternate means of nutrition). There’s also a lot of patient advocacy and explaining to doctors why we are recommending what we’re recommending, and getting them to implement your recommendations. Also, at least where I work, there’s a lot of camaraderie amongst my fellow RDs, and we work together as a team on interesting patient cases to determine the best solutions to nutritional problems.It’s a challenging and rewarding job, and you get to see and learn about a lot of very interesting medical conditions and procedures.

So that is what I do on a day-to-day basis. In the meanwhile, if you are a student currently applying to dietetic internships, good luck! If you’re thinking about becoming a dietitian, feel free to reach out with any questions, I would be happy to answer them!

Hi there! It’s been a very busy summer, I feel like I blinked and it was over. For this summer, I decided to do something a little different from my typical weekly food shops and signed up for a CSA.

CSA is short for Community Supported Agriculture. Basically, you pay a lump sum at the beginning of the growing season to a farm, and in return, you get a “share” of their produce every week. After researching the different CSAs available in my area, I decided to go with a partial share from the Turtle Bay CSA. The vegetables are grown by Free Bird Farm in upstate New York (which also services other CSA’s throughout New York City). Every week from around mid-June to mid-November, the CSA has a vegetable pickup where they hand out the week’s vegetables. In return, you must volunteer at least once at a vegetable pickup to help things run smoothly. Additionally, if you want to pay a little extra, you can purchase an egg share, a butter share, a maple syrup/honey share, a poultry share, ground beef share, and/or a fruit share. Click here to learn more about what a CSA is, how it works, and where to find one near you in NYC.

You don’t have a say in what vegetables are given out each week, and a lot of what the farm produces depends on the weather and the rain conditions of the season. For instance, this summer has been dryer than previous summers, and therefore the vegetables we received this year were a lot different than last year’s produce. Additionally, the farmers of Free Bird Farm send out a weekly newsletter that share a little bit about life on the farm, the work that goes into growing a successful crop, a detailed list of what vegetables are being offered that week, and different recipes incorporating those vegetables.

The vegetables I’ve received so far have been varied and interesting, but we still have received a lot of the familiar vegetables that I’m used to eating. So far we’ve gotten a lot of garden tomatoes, garlic, eggplant, red potatoes, cabbages, and beets. Some of the weirder vegetables of this season include kohlrabi, fennel, japanese radishes, and tongue of fire shell beans. There has also been a lot of salad greens, red lettuces, and kale. I have been loving it so far, because the CSA has been getting me out of my comfort zone of buying the same vegetables over and over, and has been pushing me to discover new recipes that I typically wouldn’t try. Of course, when I have no idea what to do with a vegetable, which will occasionally happen, I can rely on cubing it and roasting it with olive oil, salt, and pepper, and eat it as a side dish throughout the week, and that works just fine (usually my standard temperature and time for vegetable roasting is 350 degrees for 30 minutes – stirring the vegetables at the 15-minutes mark).

I also find that the fresh herbs and vegetables that I’m used to eating, like the tomatoes, carrots, and lettuce, taste so good and stay fresh for way longer. This may be likely due to the reduced transit time from the farm to my kitchen. Also, the vegetables you get are actually in season, and are therefore at the peak of freshness and their highest nutritional quality.

Some tips if you’re thinking about joining a CSA next season:

Start a Pinterest page that’s dedicated to the vegetables you get from the CSA to keep everything in one place. My CSA Pinterest board has been a lifesaver.

Save the greens of everything. Radish greens, turnip greens, and especially beet greens are delicious when sauteed with oil, salt, pepper, garlic, and onions, and although it may seem like too many greens when you pick up your vegetables, they usually cook way down. This is an easy way to reduce waste and to give your meals a big nutritional boost.

If you really don’t like something, you can swap it for something else at your pickup location. I try not to do this because I want to try everything, but if we get something that I know I just won’t eat and would prefer to have more of another vegetable, then I will swap it.

Kind of along the lines of the above point, if you don’t think you will like something, be open to trying it. I honestly did not think I liked kale or beets before this summer. Now, after researching different ways to cook them, I love them. I’ve made countless kale-based smoothies, beet chips, and beet hummus. I don’t even dream of swapping these super-foods out.

WASH EVERYTHING. INVEST IN A GOOD SALAD SPINNER. The farm does a pretty good job with hosing everything down before handing out the vegetables, but that doesn’t mean you won’t find the occasional critter or dirt in your pickup. Gross, yes, but remember these vegetables are fresh from the farm and it’s as natural as you can get.

Talk to other people when you’re at the pickup to get ideas for how they cook and eat their veggies.

Enjoy it! This CSA season has about a month left and I honestly am so sad. But I’m going to keep looking for the more out-of-the-box veggies at the supermarket over the winter.

If you want more of an idea for what type of vegetables, fruit and other food items that can come in a CSA, check out the Turtle Bay CSA website (link above in text). Also, check out my friend and fellow dietitian Rachel Greenspan’s amazing instagram. She belongs to a CSA that uses Free Bird Farm as well, and makes amazing and beautiful dishes. The link can be found here: wholegreens.

Caprese salad with lettuce greens, fresh basil, tomatoes, and mozzarella.Easter Egg Radishes!Easter egg radish, sweet potato, and kohlrabi, pre-veggie roastFresh corn veloute soupAnother crazy roast of kohlrabi, fennel, and golden beets.Hi! Me volunteering at the veggie pickup – weighing out red potatoes and studying a kohlrabi – which honestly looks like an alien.My first attempt at making spaghetti squash! Only got one of these things so far, wish we had more.An example of the beet hummus I made for the Pretty Little Liars finale – felt the rich red color and “A” was appropriate. Recipe can be found on my Pinterest CSA board and it is AmAzing (see what I did there?).An example of just taking all the greens and throwing it in a pan with some chicken, this dinner is basically a hodge-podge of all the different greens, purple cabbage, and easy.Bacon and escarole soup. First time I ever had escarole, now a big fan (bacon does that with a lot of foods, doesn’t it?).

Lately I’ve been getting a lot of questions from my patients, family, and friends about artificial sweeteners and sugar substitutes. Many wonder if they’re good for you, if they’re bad for you, and what the risks and benefits are of consuming sweeteners other than sugar. To be perfectly honest with you, when a patient asks if artificial sweeteners are safe to consume, I really DON’T know the answer. I myself am a regular consumer of artificial sweeteners; I always end my coffee order with “Skim and two Splendas,” and this makes me feel as though I don’t really have a right to tell my patients to avoid them if I eat them every day, right? There is an assumption that artificial sweeteners like aspartame are carcinogenic, but then how are could they be so prevalent in the food supply? My intention with this blog post is not to sway your opinion on artificial sweeteners in any direction, only to present the information I found and what I would recommend if someone were to ask me my opinion in the future. I found this thorough overview article from The Mayo Clinic that breaks down the different types of sweeteners out there, along with their risks and benefits. Here’s what they had to say.

Sugar substitute is a term that can cover any sweetener that can be used in place of sugar, such as:

Artificial sweeteners may be completely synthetic or can be derived from natural substances, however most of them have a much higher degree of sweetness than actual sugar. They are zero calories, because technically they’re not actually carbohydrates, and are widely used throughout the food supply, more specifically in diet products, like diet sodas and desserts.

The Good: Artificial sweeteners do not cause tooth decay and leave a sweet taste without the calories. Artificial sweeteners are also beneficial for people with diabetes, because they do not elevate blood sugar.

The Bad: Even though they’re zero calories, they may increase your cravings for more sweet things (the mechanism behind this is still unknown). Additionally, some artificial sweeteners leave a horrible aftertaste.

The Controversial: Some believe that artificial sweeteners, like saccharin and aspartame, are linked to cancer. But based on large amounts of both human and animal studies, artificial sweeteners are deemed Generally Recognized as Safe, or GRAS, by the FDA. In a study conducted by the National Cancer Institute, those who drank artificially sweetened beverages were not at an increased risk to develop blood cancers such as lymphomas, leukemia, or brain tumors when compared to those who abstained from artificially sweetened beverages. The FDA recommends that artificial sweeteners are safe when consumed in moderation, and have acceptable daily intakes for each type of sweetener:

Acceptable Daily Intake (ADIs) for Popular Artificial Sweeteners: are determined based on body weight. The following amount of tabletop sweetener packets that you would find in a coffee house is based on a 60kg, or 132 pound, person:

Sugar Alcohols are just as sweet, if not less so, than natural sugar, and are found in nature or can be manufactured in a lab. They are often utilized not only in processed foods, but in general household items like gum, toothpaste, and mouthwash.

The Good: Sugar alcohols are less processed by the body when compared to regular sugar, which can keep blood sugar levels low for diabetics.

The Bad: Sugar alcohols are real carbohydrates, so they contain calories and therefore may not be as effective for weight loss. However, they only contain only 2 calories/gram as opposed to the 4 calories/gram found in sugar. Also, when consumed in high amounts (anywhere between 10g and 50g), sugar alcohols can have an osmotic effect and pull water into the gut, causing diarrhea, bloating, and gas.

Novel Sweeteners: The FDA has approved the use of highly refined stevia (found in products like Coke Zero and in Truvia), however not whole leaf or crude stevia extracts, as the consumption of these forms of stevia plant may lead to kidney problems, and have yet to be deemed GRAS by the FDA.

Natural Sweeteners are often found in the home and are added to all different types of foods to enhance the sweetness.

The Good: natural sweeteners are chemically very similar to regular sugar, and they are both broken down to fructose and glucose in the body. If you’re not into chemicals and man-made foods products, then natural sweeteners are obviously a good choice for you.

The Bad: There’s really no health advantage to consuming a natural sweetener over regular sugar. People generally pick natural sweeteners because of taste. Since they’re nutritionally similar to real sugar, they contribute to tooth decay, elevated blood sugar, weight gain, and high blood cholesterol. It should also be noted that even some “natural” sweeteners aren’t completely natural, and may go through some sort of processing before hitting the shelves.

The bottom line: as dietitians say with most other foods, everything is good in moderation. Having a packet or two of an artificial sweetener in your coffee every morning will likely not increase your risk of developing cancer, diabetes, or hyperlipidemia. However, relying too heavily on “diet foods,” that contain other highly processed and unnatural ingredients may not be so good either. Additionally, you could be toeing the line between “enough” and “too much” without even realizing it, as artificial sweeteners can be found in a plethora of unexpected places like protein powders, yogurts, frozen yogurts, chewing gum, snack foods, salad dressings, etc. Focus on eating a generally balanced, healthy diet that consists of natural, whole foods, and you should be fine using a little bit of whatever type of sweetener you so desire. After all, what is life without a little sweetness?

In the hospital where I work, I cover two floors that treat patients specifically for heart disease and its related comorbidities. Therefore, a fair percentage of my patients ask questions pertaining to diet and what they “should” and “should not” be eating. A big question that’s been asked many times lately is what the best type of oil is to use while cooking. More specifically, is coconut oil better than olive oil? It’s a valid question, considering coconut oil has been recently touted in the media as a superfood with many multi-faceted health benefits.

I personally use both coconut oil and extra virgin olive oil, but for different purposes. For instance, I like to use a teaspoon of coconut oil when sauteing vegetables, because I feel as though it can take to higher heat a little better. Meanwhile, I like to drizzle olive oil over proteins and vegetables when roasting them in the oven, and to dress up my salads and pastas.

The truth is, you can Google “coconut oil benefits and uses,” and a million pages from unreliable blogs and websites will pop up. But, when doing a brief search through scientific publications, I found that straightforward human studies comparing the health benefits of coconut oil consumption to olive oil consumption is limited. One review article I found reported that virgin coconut oil (less processed than refined coconut oil), does have some heart healthy benefits secondary to its medium-chain fatty acid (MCFA) content. A little background: MCFAs are absorbed in the intestine faster than long or short-chain fatty acids, and are used up for energy more quickly in the liver, reducing fatty acid levels circulating in the blood. Virgin coconut oil also has antioxidant properties, which can lead to improved cardiovascular health and reduced inflammation. Studies examined in this article found that MCFA supplementation helped promote weight loss and healthy cholesterol levels. This all sounds great, but the authors were unable to make a conclusive statement that coconut oil was actually better than olive oil, because coconut oil is also rich in saturated fatty acids (which cause it to be solid at room temperature, like butter). Saturated fatty acids are more greatly associated with inflammation and high cholesterol, which can worsen your overall risk for cardiovascular disease. So clearly, there’s no conclusive evidence here that coconut oil consumption may actually be amazing for your heart health or if it deserves to be lauded as a superfood.

If you want a simple, straightforward, side-by-side comparison between coconut oil and olive oil, I found this infographic from the Cleveland Clinic that breaks down the main differences between olive oil and coconut oil. The conclusions are to stick with olive oil, because it is higher in monounsaturated fats (or MUFAs, which allow it to be liquid at room temperature as opposed to solid. I know, there are SO MANY KINDS of fats). MUFAs have been extensively studied and are known to decrease overall inflammation and cardiovascular disease (even more so than medium chain fatty acids). Other good sources of MUFAs include salmon, almonds, and avocados. You can check it out below, and find the full article here.

Bottom line: If a patient with heart disease were to ask me which oil they should use, I would recommend olive oil, and to use coconut oil sparingly due to the saturated fatty acid content. What else have you heard about coconut oil? Sound off in the comments!

So recently, I finished binge watching Gilmore Girls on Netflix. It brought me back to my days after middle school when I would come home, turn on ABC Family, and just watch for hours. I feel like rewatching it now has given me a much better appreciation of Lorelai and Rory, their fast-paced banter, their over-involved references to pop culture, and their strong mother-daughter bond. (Although *SPOILER ALERT,* I’ll admit I had to stop watching before Lorelai and Luke broke up and she went off to Europe and married Christopher. Ugh.).

Other than a newfound appreciation for the amazing writing (before the plot lines got a little too ridiculous, true fans you’ll know what I’m talking about), I also had a new appreciation for the Gilmore Girls’ love of coffee. I can now definitely relate as I start off almost every morning by brewing three cups of coffee in my mini Mr. Coffee coffeemaker. I feel like I’m sleepwalking without it, and I think it actually helps my productivity and focus at work. But watching Gilmore Girls in its (almost) entirety has made me question the risks and benefits of regular, coffee drinking. Are Lorelai and Rory, and myself for that matter, headed for a lifetime of heart problems and doom? The answers may actually surprise you.

The Good:

Coffee contains nutrients such as magnesium, potassium, niacin, choline, and vitamin E, that work as antioxidants and help your body carry out many energy-producing functions.

Coffee helps protect against the development of Alzheimer’s Dementia and Parkinson’s disease.

Consumption decreases the risks of colorectal cancer and liver cancer.

A study by the National Institute of Health (NIH) found a lower incidence of depression in those who drank at least four cups of coffee compared to those who do not drink any coffee.

The caffeine in coffee can provide fuel that can be used in sports that require long-term energy, such as in cycling or running races.

The Bad:

More than five cups/day can lead to an increased risk of a heart attack or coronary heart disease.

More than five cups/day can also lead to an increase of cardiac arrhythmias or atrial fibrillation, both of which can lead to strokes.

Caffeine is a stimulant and can cause increased blood pressure after consumption.

Unfiltered coffee, like espresso or boiled coffee, is associated with an increased consumption of oily compounds, which can increase your LDL, or “bad,” cholesterol, and further contribute to heart disease. These effects were not found in filtered coffee consumption.

Some people have an allergy to caffeine that causes them to experience nervousness, irritability, GI distress, anxiety, or tremors.

Coffee intake of greater than 3 cups/day while pregnant may increase the risk of miscarriage. If you’re pregnant and still need your morning fix, talk to your doctor about what’s safe to consume.

If ethics are important to you, look for coffee that states it’s “fair trade” on the label (same with chocolate). You can find out more about that here.

The world’s largest producer of the coffee bean is Brazil.

The largest coffee chain in the world is Starbucks, with over 20,000 stores worldwide.

My Conclusions:

If you’re already hooked on coffee, there’s no need to stop drinking it now! It has shown to have plenty of health benefits when consumed in moderation (3-4 cups/day). However, if you find that you consistently drink greater than 5 cups/day (about 40 oz), you may be at an increased risk for heart disease, high blood pressure, or high cholesterol. Also be mindful and try not to go overboard; avoid ordering coffee drinks with a lot of flavored syrups and whipped cream (like Frappucinos or Coolatas). These drinks contain a lot of calories from sugar and fat and therefore may cancel out all of the wonderful health benefits.

Hopefully Richard and Emily can refer the Gilmore Girls to a good cardiologist.